Israel pulls out of Al-Shifa following “all-out urban warfare”

Israel pulled out of Gaza’s Al-Shifa hospital on April 1st following an intensive two-week military operation against Hamas, leaving behind ruined buildings and charred bodies in the sprawling complex, according to the Arab News and agencies. 

Accounts of what happened vary.

The Israeli Defence Forces (IDF) declared the 14-day period on the hospital complex — the largest in the territory — as “precise operational activity.” Those surviving dispute the claim that the operation was “precise.” 

The IDF said its troops had “eliminated” a “terrorist base” in Al-Shifa, killed at least 200 militants from Hamas and other groups, arrested 900 people suspected of being militants, and seized weapons and intelligence. 

Hospitals throughout Gaza have become the consistent targets of raids and strikes — most of which killed or displaced the countless people seeking both medical aid and refuge there. The IDF has repeatedly claimed that Al-Shifa is home to a Hamas command centre after having intercepted communications indicating militants were regrouping at the hospital compound. Hamas had denied this. 

However, following Israel’s first raid on Al-Shifa in November, Israeli officials claimed they had found a tunnel beneath the hospital leading to weapons storage areas. On March 31st, a senior Israeli officer told reporters that, once the troops left in November, Hamas fighters returned to seek shelter among civilians.

“At 2:30, after midnight, they stormed the reception area, killing people and bombing indiscriminately,” one patient — trapped in Al-Shifa Hospital during Israel’s March 18th raid — told a local reporter. The IDF claimed no patients or civilians had been harmed.

Gaza’s health ministry said at least 400 Palestinians were killed in the two-week operation. They added that the number is expected to rise as Al-Shifa’s medics and local volunteers continue to recover bodies from inside and around the facility.

READ: Israel Supreme Court halts Palestinian patients’ return to Gaza

An April 1st report by the Euro-Med Monitor — an independent NGO headquartered in Geneva —  said that although the exact number of casualties remains unknown, “preliminary reports suggest that over 1,500 Palestinians have been killed, injured, or are reported missing” in and around Al-Shifa.

The NGO later confirmed that “hundreds of dead bodies, including some burned and others with their heads and limbs severed, have been discovered both inside Al-Shifa Medical Complex and in the hospital’s surrounding area.”

Another report from March 27th claimed that 13 children had been shot dead. The NGO declared the raid a “war crime” and a “flagrant violation of international law,” adding that its field team had “received identical testimonies about the killings and executions of Palestinian children between the ages of four and 16.”

“The army employed the most horrific killing methods,” the patient added, “and of course, they humiliated and insulted us. They threw a bomb in here. They deliberately fired at the walls.”

An Agence France-Presse (AFP) correspondent reported seeing “one badly decomposed body bearing tyre marks, although it was not known when it was driven over.” Several doctors and civilians also told AFP they had found at least 20 bodies that “appeared to have been driven over by military vehicles.”

Al-Shifa has now been knocked out of service indefinitely and has “been fully destroyed,” said the complex’s director and one of its physicians Marwan Abu Saada in a press briefing on April 2nd. The buildings can no longer accommodate any patients, perform surgeries, or conduct laboratory tests. “Even the management’s offices have been destroyed,” he added. 

“These buildings are now on the verge of collapse,” he said. “Not only is the facade destroyed, but the destruction inside the buildings is far worse. Bombs were planted inside the specialised surgery department. The two lower floors are in ruins.”

Recent footage and photographs show the massive scale of destruction that Abu Saada described. The main buildings have been reduced to scorched husks and gnarled metal rods, and the courtyard once home to around 50,000 displaced Palestinians sheltering in tents is now heaped with rubble.

Prior to the conflict, Al-Shifa consisted of three specialised hospitals built on a 42,000-square-metre plot: one for surgery, internal medicine, and obstetrics and gynaecology. It had a clinical capacity of 800 beds and covered the hospitalisation needs of the Gaza Strip as a whole.

Al-Shifa continued to be partially operational throughout the conflict, with its small medical team treating more than 200 patients in March, according to Doctors Without Borders (MSF). In November, MSF was forced to evacuate amid a campaign of airstrikes around Al-Shifa.

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The violence did not even spare a nearby clinic belonging to MSF, which said in a press release on April 2nd that the heavy fighting had “damaged the office, clinic, all the cars, and the generators.”

21 of the hospital’s patients reportedly died during the raid, while 107 others — including four children and 28 patients in critical condition — remained trapped inside the complex until the IDF pulled out, the World Health Organization (WHO) said.

Al-Shifa doctor Amira Al-Safady told the BBC’s Gaza Lifeline radio that 16 patients from the intensive care unit died because there was no longer equipment to treat them. 

Surgical resident Amer Jedbeh added there was no electricity or water during the siege, preventing operations on those injured after a shell hit his department’s building. Two patients on life support died after the electricity supply was cut ahead of the raid, he said. 

Euro-Med said that at least 22 hospital patients — deprived of food, medical care and water — died in their hospital beds during the siege.

On March 31st, reporters from the Washington Post invited into Al-Shifa by the IDF said the compound smelled “like death” and “of bodies” and “rot.” They noted that the hospital’s buildings “were not pancaked by big bombs, but targeted by Israel’s air force strikes, artillery fire and small arms,” describing an “all-out urban warfare.”

The reporters had been told a few Hamas operatives “might still be moving around the hospital,” but they “saw only Israeli soldiers.” They also “didn’t see a single Palestinian” during their visit, although there were 140 staff members and patients that the IDF claimed to be “sheltering” in a nearby building.

Euro-Med cited the “horrendous crimes [committed] against local families” by the IDF. Soldiers allegedly forced more than 25,000 Palestinians to evacuate their homes near Al-Shifa before demolishing and setting ablaze at least 1,200 housing units.

In the aftermath of the raid, Saada urged the need for new field hospitals amid the city’s growing medical needs. The territory has now been left without a single public hospital operating at the scale of Al-Shifa, he said, accusing Israel of systematically annihilating the healthcare system in Gaza.

WHO Director-General Tedros Adhanom Ghebreyesus shared on X that, while the territory was once home to 36 hospitals, now only ten remain “minimally functioning,” he wrote. 

The Arab News and agencies